Vascular Dementia

Vascular dementia (VaD) is one of the most common types of dementia in older adults. It causes a subtle, progressive decline of memory and other brain function, such as thinking, learning, remembering, organization skills and complex visual processing, and is caused by reduced blood flow in the brain.

VaD may be caused by a stroke, in which the blood supply to the brain becomes blocked, resulting in permanent brain damage. When caused by a single stroke, it's called single-infarct dementia. When caused by a series of small, often unnoticeable strokes, it's called multi-infarct dementia.

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Damage to tiny blood vessels that lie deep in the brain may also lead to a type of VaD known as sub-cortical vascular dementia. VaD may also occur with Alzheimer's disease, which causes similar symptoms, such as memory loss.

High blood pressure, heart disease, high cholesterol, diabetes, smoking and alcoholism may cause or increase the risk of vascular disease, such as a stroke, and VaD. It's important to promptly diagnose and treat these conditions to prevent VaD.

Males and African Americans are also at an increased risk of developing the disease.

Symptoms of vascular dementia (VaD) can develop quickly or slowly. At times, people with VaD experience long periods without noticeable changes, or may even show improvement. But if the disease is caused by aa stroke and another stroke occurs, symptoms may progress rapidly.

The condition often occurs with Alzheimer's disease, which complicates its progression. VaD symptoms are similar to those of Alzheimer's disease (AD), such as memory loss, but are usually easier to overcome with cues and reminders.

Patient evaluations for vascular dementia (VaD) are performed by a specially trained team including neurologists, radiologists, pharmacists, nurses and other health professionals at the UCSF Memory and Aging Center. The first step is to determine if a patient has dementia and if so, the cause. The most difficult part is differentiating it from Alzheimer's disease (AD), since the conditions share many similar symptoms.

The diagnosis may include:

Blood Tests — Blood tests, including tests of thyroid function and vitamin B12 levels, are a routine part of the evaluation. Tests looking for evidence of diabetes and cholesterol levels also will be conducted.

Treatments are designed to prevent and control risk factors such as alcoholism, diabetes, heart disease, high blood pressure, high cholesterol, and smoking. For example, high blood pressure and cholesterol can be treated with a combination of medicine, regular exercise and a healthy diet. Treating these conditions greatly reduces the risk of developing dementia.

Studies are being conducted to determine if medications for Alzheimer's disease (AD), such as cholinesterase inhibitors, are effective in treating VaD.